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The Journal of Clinical Psychiatry Apr 2015To comparatively analyze the efficacy, acceptability, and tolerability of various augmentation agents in adult patients with treatment-resistant depression. (Comparative Study)
Comparative Study Meta-Analysis
OBJECTIVE
To comparatively analyze the efficacy, acceptability, and tolerability of various augmentation agents in adult patients with treatment-resistant depression.
DATA SOURCES
An electronic literature search of PubMed, EMBASE, the Cochrane Library, Web of Science, EBSCO, PsycINFO, EAGLE, and NTIS for trials published up to December 2013 was conducted. Several clinical trial registry agencies and US Food and Drug Administration reports were also reviewed. No language, publication date, or publication status restrictions were imposed.
STUDY SELECTION
Randomized controlled trials comparing 11 augmentation agents (aripiprazole, bupropion, buspirone, lamotrigine, lithium, methylphenidate, olanzapine, pindolol, quetiapine, risperidone, and thyroid hormone) with each other and with placebo for adult treatment-resistant depression were included.
DATA EXTRACTION
The proportion of patients who responded to treatment was defined as primary efficacy, and the proportion of all-cause discontinuation and side-effects discontinuation were respectively defined as acceptability and tolerability, which were assessed with odds ratios (ORs) and a Bayesian random-effects model with 95% credible intervals (CrIs).
RESULTS
A total of 48 trials consisting of 6,654 participants were eligible. In terms of the primary efficacy, quetiapine (OR = 1.92; 95% CrI, 1.39-3.13), aripiprazole (OR = 1.85; 95% CrI, 1.27-2.27), thyroid hormone (OR = 1.84; 95% CrI, 1.06-3.56), and lithium (OR = 1.56; 95% CrI, 1.05-2.55) were significantly more effective than placebo. Sensitivity analyses indicated that efficacy estimates for aripiprazole and quetiapine were more robust than those for thyroid hormone and lithium. In terms of acceptability, no significant difference was found between active agents and placebo. In terms of tolerability, compared to placebo, quetiapine (OR = 3.85; 95% CrI, 1.92-8.33), olanzapine (OR = 3.36; 95% CrI, 1.60-8.61), aripiprazole (OR = 2.51; 95% CrI, 1.11-7.69), and lithium (OR = 2.30; 95% CrI, 1.04-6.03) were significantly less well tolerated.
CONCLUSIONS
Quetiapine and aripiprazole appear to be the most robust evidence-based options for augmentation therapy in patients with treatment-resistant depression, but clinicians should interpret these findings cautiously in light of the evidence of potential treatment-related side effects.
Topics: Adult; Female; Humans; Male; Middle Aged; Antidepressive Agents; Depressive Disorder, Major; Depressive Disorder, Treatment-Resistant; Drug Therapy, Combination; Patient Acceptance of Health Care; Randomized Controlled Trials as Topic
PubMed: 25919841
DOI: 10.4088/JCP.14r09204 -
Journal of Pharmaceutical and... Apr 2020A novel chiral stationary phase (CSP), based on a monolithic organic polymer chemically modified with teicoplanin, was fabricated within a 100 μm I.D. fused silica...
A novel chiral stationary phase (CSP), based on a monolithic organic polymer chemically modified with teicoplanin, was fabricated within a 100 μm I.D. fused silica capillary. The teicoplanin was firstly derivatized with 2-isocyanatoethyl methacrylate (ICNEML) and then thermally co-polymerized with the crosslinker ethylene dimethacrylate (EDMA) in presence of porogens (methanol and dimethylsulfoxide). The optimal experimental conditions (e.g., concentration and ratio of the reagents), considering enantioresolution and permeability, were systematically investigated. The prepared monolith was evaluated using scanning electron microscopy, and the column exhibited quite good morphology. In order to further evaluate the enantioresolving power of the poly(ICNEML-teicoplanin-co-EDMA) monolith, a series of basic and acidic chiral compounds were analyzed using an isocratic mode of polar organic solvents (methanol and acetonitrile) or the same solvents in combination with water (reversed-phase) by nano-liquid chromatography. Five mandelic acids and six derivatized amino acids were enantioresolved under reversed-phase mode (R = 1.22-3.47 and α = 1.43-6.33). This monolithic teicoplanin-CSP was also effective in the enantioseparations of 17 amino alcohol drugs employing polar-organic phase mode (MeOH/ACN/TEA/HOAc (80/20/0.03/0.055, v/v/v/v)). Ten of them were baseline enantioresolved (alprenolol, betaxolol, clenbuterol, isoproterenol, metoprolol, pindolol, propranolol, salbutamol, sotalol, tertatolol) (R = 1.55-2.48 and α = 1.21-1.55), while the others were partially enantioseparated (R = 1.14-1.48).
Topics: Amino Acids; Chromatography, Liquid; Cross-Linking Reagents; Mandelic Acids; Pharmaceutical Preparations; Polymers; Solvents; Stereoisomerism; Teicoplanin
PubMed: 32036299
DOI: 10.1016/j.jpba.2020.113129 -
The Analyst Apr 2024This paper describes the electrochemical behavior of five β-blockers at the polarized liquid-liquid interface formed between aqueous solution (sodium chloride solution...
This paper describes the electrochemical behavior of five β-blockers at the polarized liquid-liquid interface formed between aqueous solution (sodium chloride solution or Britton-Robinson buffers) and bis(triphenylphosphoranylidene)ammonium tetrakis(4-chlorophenyl)borate (BTPPATPBCl) dissolved in 1,2-dichloroethane (the organic phase). All measurements reported in this work were conducted using cyclic voltammetry (CV). The effects of the concentration of analytes, the pH of the aqueous phase, and applied electrochemical parameters on the analytical performance of the studied system are studied and discussed. The linear dynamic ranges (LDRs) of the studied β-blockers were in the range of 5-200 μmol L and the lowest limit of detection (LOD) value was determined for pindolol (LOD = 1.96 μM μmol L). The highest LOD value was 4.96 μmol L found for nebivolol. In addition, physicochemical parameters such as the formal Galvani potential difference (Δaqorg), formal Gibbs free energies of the ion transfer reaction (Δaqorg') and partition coefficients (log ') for all studied molecules were determined. The latter were compared and correlated with the available literature values of log . Finally, a standard addition method was used to determine the concentration of nebivolol in pharmaceutical preparations using a platform based on the electrified liquid-liquid interface.
Topics: Nebivolol; Octanols; Pindolol; Water; Borates
PubMed: 38454902
DOI: 10.1039/d3an02051g -
Angewandte Chemie (International Ed. in... Dec 2020Here, an electrokinetic extraction (EkE) syringe is presented allowing for on-line electrokinetic removal of serum proteins before ESI-MS. The proposed concept is...
Here, an electrokinetic extraction (EkE) syringe is presented allowing for on-line electrokinetic removal of serum proteins before ESI-MS. The proposed concept is demonstrated by the determination of pharmaceuticals from human serum within minutes, with sample preparation limited to a 5× dilution of the sample in the background electrolyte (BGE) and application of voltage, both of which can be performed in-syringe. Signal enhancements of 3.6-32 fold relative to direct infusion of diluted serum and up to 10.8 fold enhancement, were obtained for basic and acidic pharmaceuticals, respectively. Linear correlations for the basic drugs by EkE-ESI-MS/MS were achieved, covering the necessary clinical range with LOQs of 5.3, 7.8, 6.1, and 17.8 ng mL for clomipramine, chlorphenamine, pindolol, and atenolol, respectively. For the acidic drugs, the EkE-ESI-MS LOQs were 3.1 μg mL and 2.9 μg mL for naproxen and paracetamol, respectively. The EkE-ESI-MS and EkE-ESI-MS/MS methods showed good accuracy (%found of 81 % to 120 %), precision (≤20 %), and linearity (r>0.997) for all the studied drugs in spiked serum samples.
Topics: Acetaminophen; Atenolol; Blood Proteins; Chlorpheniramine; Clomipramine; Humans; Kinetics; Naproxen; Pindolol; Spectrometry, Mass, Electrospray Ionization; Syringes
PubMed: 32869436
DOI: 10.1002/anie.202006481 -
Carbohydrate Polymers Nov 2017In the present study, cyclosophoraoses (CyS) (β-1,2 linked cyclic glucans, with glucopyranose units ranging from 17 to 23) isolated from Rhizobium leguminosarum biovar...
In the present study, cyclosophoraoses (CyS) (β-1,2 linked cyclic glucans, with glucopyranose units ranging from 17 to 23) isolated from Rhizobium leguminosarum biovar viciae VF-39 were modified with carboxymethyl (CM) groups, and the pH-sensitive complexation of CM CyS with pindolol was investigated. The solubility of pindolol increased 32-fold by its complexation with 5mM CM CyS at pH 10, whereas it shows no significant change at pH 3. Pindolol, a β-adrenergic blocking agent, has a hydrophobic nature at non-ionized state, and CM CyS could solubilize efficiently pindolol in a high alkaline solution. The carboxymethylation of flexible CyS allows them to present a more suitable cavity for the hydrophobic pindolol at pH 10, which is differentiated from CM β-cyclodextrin (β-CD). It can be interpreted as that the anionic repulsion effectively modulates the flexible and distorted conformation of CyS rather than rigid annular shape of β-CD. Resultingly, the highly solubilized CM CyS/pindolol complex was characterized by UV-vis, T1 relaxation, ROESY, DOSY NMR spectroscopy, FT-IR spectroscopy, SEM, and molecular modeling studies. The antioxidant activity of pindolol was also improved 260% in the complex compared to free pindolol. The use of flexible host molecules with pH-responsive substituents would be applied in the development of smart systems for sensing or in biomedical fields.
PubMed: 28917893
DOI: 10.1016/j.carbpol.2017.08.026 -
Molecules (Basel, Switzerland) Dec 2020In this work, we examine methyl nuclear magnetic resonance (NMR) spectra of the methionine ε-[CH] labelled thermostabilized β adrenergic receptor from turkey in...
In this work, we examine methyl nuclear magnetic resonance (NMR) spectra of the methionine ε-[CH] labelled thermostabilized β adrenergic receptor from turkey in association with a variety of different effectors, including mini-G and nanobody 60 (Nb60), which have not been previously studied in complex with β adrenergic receptor (βAR) by NMR. Complexes with pindolol and Nb60 induce highly similar inactive states of the receptor, closely resembling the resting state conformational ensemble. We show that, upon binding of mini-Gs or nanobody 80 (Nb80), large allosteric changes throughout the receptor take place. The conformation of tβAR stabilized by the native-like mini-G protein is highly similar to the conformation induced by the currently used surrogate Nb80. Interestingly, in both cases residual dynamics are present, which were not observed in the resting states. Finally, we reproduce a pharmaceutically relevant situation, where an antagonist abolishes the interaction of the receptor with the mini-G protein in a competitive manner, validating the functional integrity of our preparation. The presented system is therefore well suited for reproducing the individual steps of the activation cycle of a G protein-coupled receptor (GPCR) in vitro and serves as a basis for functional and pharmacological characterizations of more native-like systems in the future.
Topics: Binding Sites; Crystallography, X-Ray; GTP-Binding Proteins; Humans; Nuclear Magnetic Resonance, Biomolecular; Pindolol; Protein Conformation; Receptors, Adrenergic, beta-1; Receptors, G-Protein-Coupled; Signal Transduction; Single-Chain Antibodies; Single-Domain Antibodies; Turkey
PubMed: 33348734
DOI: 10.3390/molecules25245984 -
Journal of the American Society For... Feb 2022Combining solid phase microextraction (SPME) and mass spectrometry (MS) analysis has become increasingly important to many bioanalytical, environmental, and forensic...
Combining solid phase microextraction (SPME) and mass spectrometry (MS) analysis has become increasingly important to many bioanalytical, environmental, and forensic applications due to its simplicity, rapid analysis, and capability of reducing matrix effects for complex samples. To further promote the adoption of SPME-MS based analysis and expand its application scope calls for efficient and convenient interfaces that couple the SPME sample handling with the efficient analyte ionization for MS. Here, we report a novel interface that integrates both the desorption and the ionization steps in one device based on the capillary vibrating sharp-edge spray ionization (cVSSI) method. We demonstrated that the cVSSI is capable of nebulizing liquid samples in a pulled-tip glass capillary with a battery powered function generator. The cVSSI device allows the insertion of a SPME probe into the spray capillary for desorption and then direct nebulization of the desorption solvent in situ. With the integrated interface, we have demonstrated rapid MS analysis of drug compounds from serum samples. Quantitative determination of various drug compounds including metoprolol, pindolol, acebutolol, oxprenolol, capecitabine, and irinotecan was achieved with good linearity ( = 0.97-0.99) and limit of detection ranging from 0.25 to 0.59 ng/mL without using a high voltage source. Only 3.5 μL of desorption solvent and 3 min desorption time were needed for the present method. Overall, we demonstrated a portable SPME-MS interface featuring high sensitivity, short analysis time, small footprint, and low cost, which makes it an attractive method for many applications requiring sample cleanup including drug compound monitoring, environmental sample analysis, and forensic sample analysis.
Topics: Carbamazepine; Equipment Design; Limit of Detection; Metoprolol; Pindolol; Sensitivity and Specificity; Serum Albumin, Bovine; Solid Phase Microextraction; Spectrometry, Mass, Electrospray Ionization
PubMed: 35040644
DOI: 10.1021/jasms.1c00305 -
International Journal of Environmental... Nov 2022Pollutants mainly exist as multicomponent mixtures in the environment. Therefore, it is necessary to synthesize low-cost adsorbents that can simultaneously adsorb...
Pollutants mainly exist as multicomponent mixtures in the environment. Therefore, it is necessary to synthesize low-cost adsorbents that can simultaneously adsorb multiple compounds. This work presents the prospect of the adsorption of multiclass pharmaceuticals from the aqueous environment using an adsorbent derived from silk fibroin of the wild silkworm . The adsorbent was prepared by dissolving degummed silk fibroin and the resultant solution was cast to obtain films that were ball-milled to powder. FTIR results revealed bands corresponding to N-H and C=O stretching vibrations. Particle size distribution data generally showed two size groups in the range of 50-90 nm and 250-625 nm. The study focused on the adsorptive removal of multiple compounds consisting of eight pharmaceuticals representing various classes including a β-blocker (pindolol), anesthetic (lidocaine), stimulant (caffeine), antiviral (nevirapine), steroid (estriol), anti-epileptic (carbamazepine), and a non-steroidal anti-inflammatory drug (naproxen). The adsorption process was best fitted to the pseudo-second-order isotherm and an overall match to the Freundlich model. Thermodynamic parameters suggested that the process was mainly exothermic and more spontaneous at lower temperatures. The performance of the adsorbent was further evaluated using environmental waters and the adsorbent demonstrated good potential for simultaneous adsorption of multicomponent pharmaceuticals.
Topics: Adsorption; Fibroins; Water; Motion Pictures; Powders
PubMed: 36429640
DOI: 10.3390/ijerph192214922 -
International Journal of Pharmaceutics Oct 2014Materials which undergo self-assembly to form supramolecular structures can provide alternative strategies to drug loading problems in controlled release application....
Materials which undergo self-assembly to form supramolecular structures can provide alternative strategies to drug loading problems in controlled release application. RADA 16 is a simple and versatile self-assembling peptide with a designed structure formed of two distinct surfaces, one hydrophilic and one hydrophobic that are positioned in such a well-ordered fashion allowing precise assembly into a predetermined organization. A "smart" architecture in nanostructures can represent a good opportunity to use RADA16 as a carrier system for hydrophobic drugs solving problems of drugs delivery. In this work, we have investigated the diffusion properties of Pindolol, Quinine and Timolol maleate from RADA16 in PBS and in BSS-PLUS at 37°C. A sustained, controlled, reproducible and efficient drug release has been detected for all the systems, which allows to understand the dependence of release kinetics on the physicochemical characteristics of RADA16 structural and chemical properties of the selected drugs and the nature of solvents used. For the analysis various physicochemical characterization techniques were used in order to investigate the state of the peptide before and after the drugs were added. Not only does RADA16 optimise drug performance, but it can also provide a solution for drug delivery issues associated with lipophilic drugs.
Topics: Diffusion; Hydrogel, Polyethylene Glycol Dimethacrylate; Hydrophobic and Hydrophilic Interactions; Molecular Structure; Peptides; Pindolol; Quinine; Surface-Active Agents; Timolol
PubMed: 25148727
DOI: 10.1016/j.ijpharm.2014.08.025 -
IScience Mar 2021Adenoid cystic carcinoma (ACC) is a rare cancer type that originates in the salivary glands. Tumors commonly invade along nerve tracks in the head and neck, making...
Adenoid cystic carcinoma (ACC) is a rare cancer type that originates in the salivary glands. Tumors commonly invade along nerve tracks in the head and neck, making surgery challenging. Follow-up treatments for recurrence or metastasis including chemotherapy and targeted therapies have shown limited efficacy, emphasizing the need for new therapies. Here, we report a Drosophila-based therapeutic approach for a patient with advanced ACC disease. A patient-specific Drosophila transgenic line was developed to model the five major variants associated with the patient's disease. Robotics-based screening identified a three-drug cocktail-vorinostat, pindolol, tofacitinib-that rescued transgene-mediated lethality in the Drosophila patient-specific line. Patient treatment led to a sustained stabilization and a partial metabolic response of 12 months. Subsequent resistance was associated with new genomic amplifications and deletions. Given the lack of options for patients with ACC, our data suggest that this approach may prove useful for identifying novel therapeutic candidates.
PubMed: 33733072
DOI: 10.1016/j.isci.2021.102212